Consecutive surgical treatment of a patientwith critical aortic stenosis and combined lesionof carotid and coronary arteries: clinical caseand review

Authors: I.I. Skopin, B.A. Suerkulov, T.V. Asatryan, D.V. Murysova

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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DOI: https://doi.org/10.24022/1997-3187-2017-11-4-385-392

For citation: Skopin I.I., Suerkulov B.A., Asatryan T.V., Murysova D.V. Consecutive surgical treatment of a patient with critical aortic stenosis and combined lesion of carotid and coronary arteries: clinical case and review, Kreativnaya Kardiologiya (Creative Cardiology). 2017; 11 (4): 385–92 (in Russ.). DOI:10.24022/1997-3187-2017-11-4-385-392

Received / Accepted:  07.07.2017/28.07.2017

Keywords: brachiocephalic arteries lesions carotid endarterectomy coronary artery bypass grafting aortic valve replacement staged surgical treatment

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Abstract

Combined lesions of the carotid, coronary arteries, and heart valves significantly increase the risk of severe complications of surgical treatment. Treatment involves simultaneous or staged surgical procedures. A case of successful stepped surgical treatment of a patient with symptomatic critical lesions of carotid and vertebrobasilar basins, coronary heart disease and calcific critical aortic stenosis is presented. As a first step carotid endarterectomy was performed, and then patient underwent simultaneous aortic valve replacement and coronary artery bypass grafting.

References

  1. Skopin I.I., Samorodskaya I.V., Murysova D.V.,Asatryan T.V., Urmanbetov K.S., Valieva P.P. Thechoice of tactics of surgical treatment of patients ofolder age group with valvular heart in combinationwith coronary and brachiate-falen arteries.Angiologiya i Sosudistaya Khirurgiya (Angiology andVascular Surgery). 2013: 19 (1); 87–92 (in Russ.).

  2. Lane I., Byrne J. Carotid artery surgery for people with existing coronary artery disease. Heart. 2002; 87 (1): 86–90.

  3. Irqsusi M., Vannucchi A., Beckers J., Kasseckert S., Waldhans S., Vogt S., Moosdorf R.G. Early results of surgical simultaneous therapy for significant carotid artery stenosis and heart disease. Thorac. Cardiovasc. Surg. 2017. DOI: 10.1055/ s-0037-1601425. PMID: 28380656.

  4. Dzierwa К., Pieniazek Р., Musialek Р., Piątek J., Tekieli L. et al. Treatment strategies in severe symptomatic carotid and coronary artery disease. Med. Sci. Monit. 2011; 17 (8): 191–7.

  5. Bockeria L.A., Pirtskhalaishvili Z.K., Sigaev I.Yu.,Darvish N.A., Serguladze T.N. Modern approach-es to diagnostics and surgical treatment of brachio-cephalic Arte-ries in patients with coronary heartdisease. Vestnik Rossiiskoi Akademii MeditsinskikhNauk (Annals of the Russian Academy of MedicalSciences).2012; 10: 4–11 (in Russ.)

  6. Antonov I.M., Ishevskiy A.G., Kvitivadze N.G.,Antonova L.N., Muratov M.R., Sorkomov M.N.,Stryuk R.I. Type 2 myocardial infarction due toaortic valve fibroelastoma. Lechebnoe delo(Medical Care). 2017; 1: 6–15 (in Russ.).

  7. Skopin I.I., Darvish N.A., Kakhktsyan P.V.,Asatryan T.V. Immediate correction of criticalstenosis of the left internal carotid artery, criticalaortic valve stenosis combined with coronary heartdisease. Grudnaya i Serdechno-SosudistayaKhirurgiya (Russian Journal of Thoracic andCardiovascular Surgery).2012; 56: 16–8 (in Russ.).

  8. Eggebrecht H., Schmermund A., Voigtländer T., Kahlert P., Erbel R., Mehta R.H. Risk of stroke after transcatheter aortic valve implantation (TAVI): a meta-analysis of 10,037 published patients. EuroIntervention. 2012; 8: 129–38.

  9. Astor B.C., Kaczmarek R.G., Hefflin B. et al. Mortality after aortic valve replacement: results from a nationally representative database. Ann. Thorac. Surg. 2000: 70; 1939–45.

  10. Serguladze T.N., Bockeria L.A., Aslanidi I.P.,Darvish N.A., Comprehensive functional assess-ment of cerebral blood flow in ischemic in the vari-ations of the brain. Byuletten’ Nauchnogo TsentraSerdechno-Sosudistoy Khirurgii imeni A.N. BakulevaRAMN (The Bulletin of Bakoulev Center“Cardiovascular Diseases”).Supplement. 2012;13 (6): 130 (in Russ.).

  11. Kar S., Krishnaswamy A., Shishehbor M.H., Cam A., Tuzcu E.M., Bhatt D.L. et al. Safety and efficacy of carotid stenting in individuals with concomitant severe carotid and aortic stenosis. EuroIntervention. 2010; 6 (4): 492–7.

  12. Birchley D., Vxllaquiran J., Akowuah E. et al. Staged carotid endarterectomy under local anaesthetic in patients requiring cardiac surgery. Ann. R. Coll. Surg. Engl. 2010; 92 (5): 373–8.

  13. Naylor A.R., Cuffe R.L., Rothwell P.M., Bell P.R. A systematic review of outcomes following staged and synchronous carotid endarterectomy and coronary artery bypass. Eur. J. Vasc. Endovasc. Surg. 2003; 25 (5): 380–9.

  14. Antunes P.E., Anacleto G., de Oliveira J.M., Eugenio L., Antunes M.J. Staged carotid and coronary surgery for concomitant carotid and coronary artery disease. Eur. J. Cardiothorac. Surg. 2002; 21: 181–6.

  15. Li Y., Walicki D., Mathiesen C., Jenny D., Li Q., Isayev Y. et al. Strokes after cardiac surgery and relationship to carotid stenosis. Arch. Neurol. 2009; 66 (9): 1091–6.

  16. Prasad S.M., Li S., Rankin J.S. et al. Current outcomes of simultaneous carotid endarterectomy and coronary artery bypass graft surgery in North America. World J. Surg. 2010; 34 (10): 2292–8.

  17. National guidelines for the management of patientswith disease s of the brachiocephalic arteries.Angiologiya i Sosudistaya Khirurgiya (Angiology andVascular Surgery).2013; 19 (2): 69 (in Russ.).

  18. Brott T.G., Halperin J.L., Abbara S., Bacharach J.M., Barr J.D., Bush R.L. et al. ASA/ ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease. Circulation. 2011 26; 124 (4): 54–130.

  19. Baumgartner H., Falk V., Bax J.J., De Bonis M., Hamm C., Holm P.J. et.al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease: The Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur. Heart J. 2017; 26. DOI: 10.1093/eurheartj/ ehx391 PMID: 28886619.

About Authors

  • Skopin Ivan Ivanovich, Dr Med. Sc., Professor, orcid.org/0000-0001-7411-202X;
  • Suerkulov Beknazar Alymzhanovich, Postgraduate, orcid.org/0000-0002-5207-5763;
  • Asatryan Tigran Vladimirovich, Researcher, Cand. Med. Sc., orcid.org/0000-0002-0141-5481;
  • Murysova Dar'ya Vladimirovna, Researcher, orcid.org/0000-0003-2885-6225

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery